Here we go. A discussion of a law in our country. Questions and answers. Actually experiences of people who have looked into it - Penny's sons and Dave. So interesting, right?

BUT someone spoiled it by saying something intentionally insulting, not to one of us, but about the President of the United States. Honestly, Penny, can't you try harder to mutter your insults to yourself and not use your fingers?. The "boy" (in case you didn't know, it is a racial insult to call a man "boy") is over 50 years old and the President of our country, voted in twice by a majority of your fellow Americans.

i spent some time looking at it in detail this afternoon. It is complex because there are services with no charge like flu shots and PCP visits. And there is a deductible, but that is also the max out of pocket for a plan.

I have cooled down a bit from Penny's outrageous insulting comment and am ready to take a stab at answering some of her concerns:

1) Penny is concerned that her sons are unable to find a better plan on the exchange. That shows that they already have insurance. They found a plan with a large deductible,, but there are other plans that have low deductibles but higher premiums. The exchange gave them an opportunity to see if they could find a better plan than their current one for less money. They still may have been able to do so if they found a plan with a low deductible similar to the plan they currently have and with similar coverage but at a higher premium. They may qualify for government subsidies. If their income qualifies them for a subsidy, their premiums would be lowered by that subsidy and may be lower their current premium.

Nice that it would be if the exchange works that way for Penny's sons, the exchanges work even better for people, unlike these men, with no insurance or lousy insurance.

2)Penny, just because insurance covers something does not require any insured to use that benefit. So, no one has to be on birth control although, like erectile dysfunction drugs, it is covered by insurance. An example would be that, although your insurance covers psychiatric care, you don't have to use that benefit. So, I have no idea why you are so upset that a private insurance company will cover birth control for your sons' wives or girlfriends. That is, if they choose to get a prescription for those drugs rather than give you many, many grandchildren. Oh, maybe that's why you're so opposed to coverage for birth control for women.

3) I haven't heard anything about any $63 fee. Please give me a source for that.

4) Exceptions for Moslems? And Amish? That's ridiculous. Insurance cannot be denied on the basis of religion. I'm sure that the application on the exchange does not ask about any religious affiliation. Where are you getting this? Why would anyone want to be excluded? People want insurance. No one wants to be left out of a government entitlement. It's like saying that Moslems and the Amish are excluded from social security or Medicare. It just doesn't make sense.

5) Exceptions for Congress and the President? They already have superb insurance. Like your sons, they can go onto the exchange and see if they could find a better deal than their employer (the U.S. Government) is offering). It's similar to my insurance (and Rosy's) through our pension funds. There is not going to be anything less expensive with better coverage because our premiums are subsidized by our pension fund.

The only people not allowed on the exchanges are those getting insurance through a government plan - Medicare and Medicaid. The exchanges are open to everyone else. No one else is excluded.

6) Homeless people qualify for Medicaid and many are already enrolled (as they are in food stamps). They are not involved in the exchanges.

7) The only people who have to go on the exchanges and get insurance are people who don't have any now. Many people want to be able to get insurance and this enables them to do so. If they can't afford the premiums, the government will give them a subsidy to help pay. It won't work if only sick people have insurance. That's not how insurance works. The company needs premiums from people who are not sick to pay for insureds who are sick. Some people don't want to pay for insurance. The figure they won't get sick. But, then they get sick. So, then they get insurance. Is the insurance company supposed to lay out thousands of dollars for their care? No, Penny, it can't work that way. People need to have insurance, sick or well, and those who refuse to purchase it, even when they can afford it, either on their own income or with a subsidy, should pay a fine.

8) Finally something you agree with in the law. The ACA DOES require that everyone have insurance. That's the whole point of the law.

quote:Originally posted by PennyPA

Both of my sons went to the website to see what it would cost them if they went through obamacare. They found out it would cost them about $20 less per month but they would each have a $5000 deductible compared to the $250 deductible they have now. That's the unfortunate thing. People are rushing to join obamacare but they aren't paying attention to just how much they're really going to have to pay out if they have to use it.

I have several problems with obamacare. #1 - HUGE deductibles; #2 - If your company already has you on their insurance plan but it doesn't cover birth control and some other stuff, it is deemed an unacceptable plan and it will be dropped; #3 - I do not like the fact that if you DON'T get insurance, you will be fined yet if you DO get insurance, there will be a "temporary" fee of $63. That fee will be charged to your insurance company but you know that it will move down the line to the consumer; #4 - How are they going to fine all the homeless people or people who know nothing about this fiasco? And WHY are there exceptions to it? Muslims, Amish, Congress, the boy in the White House and his family to name but a few. If there is something that ALL Americans must have (or be fined), then ALL Americans should have to get it.

I think they should drop the whole thing and just add that people with pre-existing conditions must be covered. Period. If people want to buy plans that pay for birth control, then let them but don't make it a requirement that ALL plans have it.

1. I didn't say anything about Muslims and Amish (and others) being excluded from obamacare. There is a difference in the meaning of "Exclusions" and "Exceptions" with Exceptions meaning they don't have to take part in obamacare nor will they be fined for not doing so.2. Nor did I say anything about having to use something that was on my plan but I also would not want to have to pay for anyone else's birth control, mental health, or maternity. However, that MUST be covered in all plans under obamacare.3. I am not concerned that neither of my sons can find better plans on obamacare than they presently have. They have very good insurance and both their companies said they will keep it. They went on there just to see how hard it was to get on and what kind of plans there were. They found you either paid a high premium or had a high deductible. What's going to happen with those who go on the Bronze Plan (because that's all they can afford) and have the government pay for their plan only to find out the first time they go to the hospital that they have a $5k deductible? Or all those co-pays when they go to a doctor? This is NOT affordable healthcare for most people even with the government (you and I and everyone else) paying for it for them.4. Of course Congress and obama have excellent insurance. So do a lot of other people but if their plans aren't up to snuff according to obamacare, those plans will be dropped. If it's good enough for Americans, it's good enough for Congress and obama.5. "The only people who have to go on the exchanges and get insurance are people who don't have any now." This is not a true statement. The only people who have to go on the exchanges are those who don't have insurance AND those whose insurance plans don't meet the criteria of obamacare.6. I am not opposed to birth control for women. In fact, many women on welfare should have permanent birth control. But I AM opposed to paying for birth control for everyone else. Who paid for yours when you were in your child-bearing years, Rita?7. For the $63 fee...http://tinyurl.com/kc495uk8. Does your current health plan cover birth control, maternity and mental health?

****************************************************************Do Not Regret Growing Older. It is a Privilege Denied to Many

You can’t change the past but you can ruin the present worrying about the future.

The Bad News: Time flies as you get older.The Good News: You’re still the pilot.

You know, I thought this forum deleted or tried to minimize political statements. Or, is it just that the ones that get deleted are on the side of the discussion that someone doesn't agree with??Whether anyone likes it or not, Obamacare - the name for this mess that the majority of the citizens in the U.S. call it - it totally a one sided political program. I would guess the only thing both of you would agree on is as stated above by Rita, Obamacare is "government entitlement".I really doubt that there are a lot of folks on here that really want this forum's advise about Obamacare. So, how about thinking about dropping this subject completely off the forum since it is a highly controversial "political subject"?Obamacare will eventually be cured, one way or another. Our COPD won't! Why don't we focus a little more on what this forum's primary justification is? If this offends somebody, let me know and I'll assign you a number to get in the line of people I offend.

Well, you can't give me a number, Sam, because very rarely, if at all, do you say anything that offends me. The trouble with dropping it completely is that there are some people on the board who are not yet on Medicare so it will affect them.

****************************************************************Do Not Regret Growing Older. It is a Privilege Denied to Many

You can’t change the past but you can ruin the present worrying about the future.

The Bad News: Time flies as you get older.The Good News: You’re still the pilot.

The ACA is a fact of life, and not all are on medicare or medicaid on this group. Some need to buy insurance, and I can tell you my cost would be less than it was a decade ago on our small business plan.

One of the problems is that health plans are controlled by states, but must meet federal minimum standards. Residents of some states have come out better than others.

If you want to look at this link, you can look at policies. Certain services like preventive care are not covered by the deductible. Also under the law, insurance companies must spend 80% of premiums on care.

I don't understand this situation. My nephew(17) is on a seperate health policy because including him on his parents policy thru hi fathers work is very expensive so he has a deductible policy at $125. Upon renewal in the past 2 weeks it went up to $175 with a higher deductible and a 6% surcharge to go toward ACA. Why is someone buying their own insurance being penalized with a surcharge? His parents in their 50's pay over $1500 a month( which just went up again) for the 2 of them and they work for the county and the county pays part. I don't understand this surcharge.

Penny I took a stab at addressing your concerns. I give up. Thank you for a good laugh. I not only am on Medicare so way beyond any concerns about birth control or maternity but I also had all those parts removed many years aga due to cancer.

Medicare and social security are the entitlements they are talking about cutting back. Since you asked until I became eligible for these entitlements i never had government help or took charity of any type. I had private insurance and paid for whatever wasn't covered including the 20% copay for my surgery and other treatment for cancer.

I assume the same was true for your lvrs. But some people don't have pri vate insurance like we had. This law is meant to help them. It may not be the best way to do it but it is the law and no one has come up with another way to help people who do not qualify for Medicaid.

Sam since this topic upsets you I encourage you to skip it. Why read something that is bothering you to such an extent that you want to cut it off for everyone?

I think it's important to keep this topic alive. Yes, it is a little political, but there will be some good information available here. We all have our opinions about Obamacare, those who are in favor and those who are not. It's a good read, and no one should take it so personally.

Rita, here's what Paul and I are talking about: "Muslims are specifically exempted from the government mandate to purchase insurance, and also from the penalty tax for being uninsured." It's called Dhimmitude.

Paul, I think Rita was just confusing the words "Exclude" and "Exempt". What I find a little difficult to understand is the fact that muslims do not have to sign up and yet Christians, that may be against abortion, have to sign up or be fined if they don't. I guess the muslims have a better lobby than Christians.

Now, I wonder if because they don't have to have insurance, if hospitals and doctors can say "No" to treating them?? They should be able to since one of the purposes of obamacare is to get everyone under government insurance.

****************************************************************Do Not Regret Growing Older. It is a Privilege Denied to Many

You can’t change the past but you can ruin the present worrying about the future.

The Bad News: Time flies as you get older.The Good News: You’re still the pilot.

Q: Will Muslim Americans be exempt from the mandate to have health insurance?

A: The Muslim faith does not forbid purchasing health insurance, and no Muslim group has ever been considered exempt under the definitions used in the health care law.

quote:In our article "More Malarkey About Health Care," we wrote that some religious groups may indeed be considered exempt from the requirement to have health insurance. The law defines exempt groups using the definition from 26 U.S. Code section 1402(g)(1), which describes the religious groups currently considered exempt from Social Security payroll taxes. Eligible sects must forbid any payout in the event of death, disability, old age or retirement, including Social Security and Medicare.

Since we posted our article, we’ve obtained a list through the Freedom of Information Act of all the groups that have successfully applied for exemptions from payroll taxes. (We have posted the Excel file here.) The overwhelming majority of them are explicitly Anabaptist — that is, Mennonite, Amish or Hutterite. Those that don’t specify their denomination are still explicitly Christian. Having gone through the list, we can say with certainty that no Muslim group, and indeed no non-Christian group, has ever qualified for an exemption under the statute used to define exempt religious groups in the health care law.

Sok - you misread Penny's post. She doesn't want to pay for anyone's maternity coverage, including yours. How she ends up paying for your private insurance, you'll have to ask her (Penny wrote: ... I also would not want to have to pay for anyone else's birth control, mental health, or maternity.)

What do you want me to look up? ???? I'm petty confident that I understand how the exchanges work. Does Page 107 of the ACA give an exemption from having health insurance to Moslems? The copy of the law that I saw is arranged by section, not page numbers. Would you please copy and post the exact language on Page 107 (or elsewhere in the Act) that says Moslems are exempt. Or, see below.

Oh, Penny, I thought we were through and agreed to disagree but you are sucking me in again. From Wikepedia: A more recent pejorative usage variant of "dhimmi" and "dhimmitude" divorces the words from the historical context and applies them to situations where non-Muslims in the West and India are championing Islamic causes above others. "Dhimmi" is treated as analogous to "Quisling" within this context.[citation needed]Sidney H. Griffith states that it "has come to express the theoretical, social condition" of non-Muslims "under Muslim rule".[12]According to Bassam Tibi, dhimmitude refers to non-Muslims being "allowed to retain their religious beliefs under certain restrictions". He describes that status as being inferior and a violation of religious freedom.[13]

Before you quote something, you really should verify that the source is reliable. Of note, you didn't tell us the source so I found this on PoliFact.com/truthometer which explains that an email going around claims that page 107 of the ACA says Moslems are not required to have insurance:

"We know this because of our previous reporting on the law, and also because we did a full-text search on both the main law (the Patient Protection and Affordable Care Act) and a companion law (the Health Care and Reconciliation Act). It’s not in either one."

Aren't you relieved that Moslems are not exempt or excluded or treated any differently than any other religious group and we are not being subject to dhimmitude? You might want to get off that email list because they are telling you lies.

I'm sure that the President and members of Congress would be happy to have a resource like the exchanges if their insurance was canceled. Please give me a reliable source (and not some bogus email) where it says that their insurance does not include the coverage for preventive medicine (mammography, colonoscopy, flu shots, etc.) without a co-pay or any of the other requirements forced on insurers by the ACA. The plans that do not have the required coverages are being canceled so people in those plans do not have insurance and they have to get it. (Some plans are being grandfathered in even though they do not have the required coverages.)

The exchange is a device where insurers offer various plans. A person who is looking for insurance can (does not have to, but can) go on the exchange to compare the various plans. Then s/he must enroll in it through the private insurer.

The exchange is a marketplace, like Amazon, where you can view different offers. You can "buy" it without going through the exchange by going directly to the insurance company. Humana is running ads on tv here encouraging people to call and discuss Humana's plans. Of course, if someone does it that way they won't be able to compare Humana's plans to let's say Blue Cross or any other insurer offering plans in that state. If you google the Affordable Care Act, you will find lots of insurers have sponsored sites. I assume they are looking for business and hope to grab some uninsured people without them going on the exchange and comparing plans.

As for me, as I said, I'm on Medicare. Do you know if it covers the things you care so much about like birth control? I haven't had a need for that benefit for many years (as I explained, I had those part surgically removed long ago) so I haven't looked into it. I, though, am very satisfied with my Medicare insurance and only wish everyone could be covered so well for so little money.

How about you? Does your plan cover birth control and is that why you're so upset about it?

Btw, all I've been hearing on the news is that the website is not working and no one can get in. But, look at the people who have posted that people have gotten in and looked at the plans - Penny's sons, Carol's nephew and Dave. Hmmm, interesting.Rita

Rita-- I will make one last comment then I am done with this subject ( see the sixth post on page one, that is how I feel ) I am not saying you do not know how the exchange works. The exchange is only one part of this bill. There are ways within the legislation to opt out if you get approval. Let's all take a deep breath and SMILE!! Thanks Paul

Regarding the Amish and I believe the Mennonite also, they take care of their own.

Amish are exempt from the mandate because of a “little-known” 60-year-old provision. Why can’t the rest of you be exempt? Because the Amish already have a functioning health care system of their own.

“While practices vary by community, most Amish fund their health care through a system that merges church aid, benefit auctions and negotiated discounts with local hospitals, promising quick cash payment in exchange for lower rates.”

Please don't close the topic Dave. I think it's important to have these conversations, even if they get a little political. I'm sure we will be hearing from those who have to purchase insurance and what their experience was like, what they were able to find, etc.Rosy

Dave, I was not trying to complain about third party problems. I have heard nothing about a surcharge for people that do get insurance. I was only using my nephew as an example of something I hadn't heard of. It doesn't seem right to put a surcharge on the people that do get insurance. It makes no sense as the wrong people are being penalized. I am sure that if this the standard that it will keep people from signing up.

The insurance company is charged for every policy they write the fee. Also big companies that self insure. This is really a risk underwriting pool, so that if an insurance company has higher than average losses (over the total premiums), they can recover some of the money from the pool.

Purpose of Reinsurance Fees. Beginning in 2014, certain health insurance issuers in the individual and small employer markets will become subject to new restrictions on how they price health insurance and the conditions under which they provide the insurance. These additional risks could cause some insurers to cover higher-risk populations and could adversely affect insurers’ financial situation. The Affordable Care Act (“ACA”) provides temporary “reinsurance” payments to insurers who cover these higher-risk populations. Unfortunately for employers, the reinsurance payments will be funded through a “reinsurance” fee, payable by employers.

Then,is tnis right, Dave?As an employer, I pay extra money that I work for and made into a government account set up to make sure that the insurance companies do not lose money because of this law. Did I get that right?

“As democracy is perfected, the office of president represents, more and more closely, the inner soul of the people. On some great and glorious day the plain folks of the land will reach their heart’s desire at last and the White House will be adorned by a downright moron.” H.L.Mencken 1920

I agree. We struggled for years as a small business and one or both of us having health issues they like to charge a fortune in premiums. I have a client with over 1,000 employees. The $63 a year ($5.25 a month) is part of the premium.

I never worked in health insurance but reinsurance is common in the insurance industry. Insurers need protection against paying out more than they take in. High risk insureds' costs need to be spread out. You would need to look at what the reinsurance costs were prior to the ACA to learn if the $63 is high or low. It really isn't something for the insured to worry about.

Well for what it's worth I do not have insurance and have COPD. I was automatically approved for SSDI but have to wait 2 years and 5 months because it only took 10 days from application to approval for SSDI. I turned 59 today so Medicare is no help yet.

I have been without my group coverage since 6/30/2013. I am on the verge of a financial disaster should I not get insured and have a major hospitalization. Been paying for Dr visits and meds out of pocket. Thank the Good Lord for ADC and Health Warehouse in the USA for generics.

I enrolled electronically on the first day, however could not get identity verified. So dead end.

Then a week later I applied online with a spokesperson and mailed id paperwork and income verification to Kentucky. When I called back a week later seems both applications have been lost. So now I cannot make a new account or sign in because my SS# prevents it.

Well on 22nd of October I called again and re applied with a spokesperson. Today I call to check status and they say wait 2 more weeks. But they assured me that the site is not the cause. I have read that even paper apps have to be keyed in but I do not know.

As for paying insurance for other peoples insurance I will gladly pay as they have paid a lot for my COPD and I do not mind in the least since they pay for us.

I live in Arkansas and we use the Federal exchange. Will update as soon as possible. BTW deductible is only $500.00 for top Silver Plan and stop loss $2,250 for me only, wife already has medicare and supplement. It is income based and both myself and my wife will be on SSDI come Jan 1st. We will just supplement with savings till I have to draw from retirement.

Mike, I hope you can get it done. It is a pity that the geeks didn't do a better job setting up the website. It should be a lot easier and a lot faster. Please let us know how it develops. I can't begin to imagine how hard it must be to have a chronic disease and no insurance. (I assume you didn't qualify for Medicaid?)

Good luck to you. I'll keep my fingers crossed that you soon have insurance.